Anxiety

I knew it was going to be a crappy one as soon as I realized I needed to switch my medication. I’ve had mental health issues for half my life. I knew that trialling new medication had the potential to go either way. I also knew that, should I need to return to Effexor, that I could easily write off a couple of months as my body adjusted to the lower dosage.

I was right on both counts. This year has been tremendously difficult. However, I was prepared for the suckiness. With the help of my team (doctors, job network and psychologist), I identified and worked through a lot of my health barriers. As a result, I’m feeling better than I have in years.

In this post, I explore what it was like to essentially lose my mind and get it back again. I am so, so grateful.

Returning to Effexor

The last essay I wrote was early December 2016. At that point, I had been on Pristiq for a couple of months and had finally started to cope with nausea.

I could handle the discomfort, but it meant that I would struggle if I was in a car for too long. I was skipping meals. I kept on having pregnancy tests because surely, this side effect couldn’t last this long.

I was so angry, but also terrified. I may have felt like I was going to throw up all the time but at least my brain was semi-functional. I knew that returning to Effexor would mean starting at the lowest dosage. I would be starting at 37.5 mg which has barely any impact on me.

Losing My’ Brain’

I was right. I didn’t have the courage to seek a medication change until April. I could feel the cognitive decline immediately. I wrote Bloggers To Watch In 2017. Initially, it was meant to have 15 bloggers. I got to number 7 and stopped being able to put sentences together in a paragraph. I couldn’t make sense of the disconnected bits of information.

I wasn’t allowed to increase my medication dosage for a month. It would take 3 months until I would be on my optimum dosage and, even then, it would take a while for my body to adjust to it. I hadn’t read for months but now I couldn’t do much at all. It impacted every facet of my life.

I was constantly exhausted, even more than before I moved to Pristiq. My memory was shot. Glenn is still reminding me of how I reacted to movies and situations. I struggled in conversations. I was crying from sheer frustration a lot and had no self-worth left. I had no mental energy left to fight off the negative self-talk and it was ruthless.

It scares me now to think about how rough this time was. I’m scared that the Effexor will no longer be effective in a couple of years, and I will be in a similar situation. I know that I can’t live my life according to what might happen, however, I need that awareness to prevent me from getting this sick again.

It’s worth noting that the lethargy during this time was debilitating. I would catch taxis to appointments as I couldn’t handle the bus. I didn’t do much housework, compounding the guilt I had about being a leech.

Exploring DBT

Around this time, I switched to a new psychologist. I couldn’t afford the regular $60 cost of my previous one. My job network was fantastic during this time, helping me find a great bulk billing psychologist that was closer to the city.

The new psych was and still is, fantastic. It was a struggle at first, as my brain wasn’t working. She would ask questions and I just couldn’t remember, or I couldn’t put a sentence together. There was a lot of frustrated crying. It got better as my health improved and, in my typical nerdy fashion, I threw myself into recovery.

I would read books based on the specific DBT strategies I was taught to make sense of how it worked. I would question everything. I’d do my mindmaps to see how a particular thought pattern impacted me.

Ironically, I wasn’t motivated by my desire to get better. I was starting to get my cognitive function back and was fascinated with the theory behind my treatment. The fact my mental health was improving was just a positive side effect.

I was resistant to a lot of the techniques at first. LovingKindness? Pft. Guided relaxation. Didn’t she know that I had tried that?

This time, it was effective. I know now that I need a combination of therapy and medication to get the best results. I need the mental energy to fight my internal negative, as well as implement the techniques.

Now, my psych jokes that I’ve done 2 years of DBT work in 6 months. Obviously, I haven’t, there is so much more work to do. It is so satisfying to know that it wasn’t laziness or selfishness that was getting in the way of me getting better. It doesn’t matter how smart you are or how much you know if your biology is that out of whack.

Eliminating Potential Aspergers

I was making a lot of progress with my mental health but was still struggling. My brain still felt like it was going slower than the world around me and it would occasionally shut down when I was too overwhelmed. My doctor eventually suggested getting formally assessed for Aspergers.

This annoyed me. There is nothing wrong with having Aspergers or being neurodivergent, but it felt like a distraction. Whenever I saw a new health worker in my job network they would bring up getting tested for Aspergers. It would lead to the inevitable conversation about how I have social phobia and that my monotonal voice is only noticeable around new people. And no, I don’t do eye contact.

There was also the fear that I may have had it. If so, I would have lost a decade where I had approached my health through the lens of an anxiety sufferer. If I did have Aspergers, the past 10 years of my life could have been a lot easier if it had been identified earlier.

I had the assessment and was assessed for a couple of mental health disorders. It came back as it always has: Severe anxiety, with the occasional depression. This meant that I, and those supporting me, knew 100% where I stood and how to approach treatment from here. It was a relief to know that I definitely didn’t have it and could address the real issue: lack of sleep.

Finally getting on top of my sleep

I had been getting my brain back but everything still felt like it was in slow motion. I struggled to handle too much information and felt physically lethargic. It was starting to upset me; I had gone off Effexor previously due to feeling exhausted while on it.

I missed my brain. I missed being able to read and connecting random ideas. I was feeling like a leech in my relationship with Glenn. Things have always been financially unequal, as he has supported me a lot over the past 6 years. I managed our finances and would see the amount in his savings go down while I was barely even contributing to the housework. As always, Glenn has been supportive and fantastic but I’m very self-critical. I’ve always told myself that I’ll contribute to the relationship more when healthier and make up for all the help I’ve asked for.

Eventually, I was prescribed melatonin. I had asked for it at the start of the year but the doctor, who wasn’t my usual one, said that it was expensive and to try panadeine instead. I asked about side effects but I was told I would be fine. The pharmacist had to explain them to me when I was denied them. I was so angry. I put off addressing the sleep because I assumed treating the anxiety would fix it. Oh, how wrong I was.

It was August/September. I would still be awake at 6am, having gone to bed at 11. I would have done the relaxation and breathing exercises. My brain wasn’t even being overly active, it was like my brain was on pause. I would struggle during the day and often have several of these in a week. Eventually, I went back for the melatonin.

It took about a week for it to work, but it’s now working beautifully. I still have issues with sleep but it is a lot more consistent. I’ve also gotten my brain back! I can read and concentrate for long periods of time. It’s bliss.

I want to explore my sleep issues in more detail in 2018, as I suspect there may be other issues interrupting my sleep. For now, I’m just trying to catch up on a year’s worth of literary brilliance.

Seeking Migraine Treatment

I’ve been getting migraines for over 7 years. Addressing the anxiety and sleep issues reduced them slightly, but they were still quite debilitating. I would get them if I had a big day. I’d get them if the weather was over 28. It felt like I had to arrange my whole life around them.

You know what? I did, and I still do. It took a while to accept them but migraines are a part of my life. In February, I was prescribed Naramig. This means that, if taken in time, I would only be in pain for 2 hours. I would skip the ‘aura’ phase and completely avoid the disorientated nausea. It wouldn’t impact my life to the extent it did in the past.

I still have to be cautious in warmer weather and make an extra effort to stay hydrated. I’m now testing preventative medication and will be exploring whether improving my fitness has a positive effect. All I know it is one less major barrier to getting my life back.

Returning To Schema Therapy

Schema therapy has always been more effective to me than CBT/DBT. CBT always feels like a band-aid solution: effective but doesn’t get to the core of the issue. Schema therapy explores the rigid mindsets that can lead the original maladaptive behaviour. You can check out the previous posts on the schema therapy page. Note: it’s a definite work in progress.

The psychologist I saw in 2011 had only just learned of the concept. We explored how my schemas interfered with my life but never did the really hard work. I made a number of behavioural changes that improved my quality of life but, as I’ve learned this year, that has just caused my behaviour to manifest in different ways.

I did another schema questionnaire. Some have changed; I no longer have the dependence/incompetence schema. I still have the social isolation and unrelenting standards one. I will be doing a lot of schema work in 2018 and hopefully, it will change how I react to stresses.

What is life like now?

2017 sucked but, as I neared the year’s end, I noticed I was feeling better than I had in years. Getting cognitive function back greatly improved my quality of life. I had to work incredibly hard to implement many psychological techniques while at my sickest. As a result, it was a lot easier to use them when I got my brain back. I can react to a lot of day-to-day stresses quite easily, provided a schema isn’t triggered.

My relationships have improved as a result. I’m not hypersensitive and have a lot more confidence, which makes it easier to interact with family and Glenn. I’m excited about returning to hobbies that I’ve pushed aside, such as birdwatching and hiking.

My lack of work and income is a huge stressor. I’ve been strict about not pushing myself until my body can handle it, as I’ve seen the result of taking employment when I’m ill. I will be working with both my job network and psychologist on finding employment, as I know the job hunting process will trigger me.

Life simultaneously feels full of opportunity and incredibly overwhelming. The journey is going to be fascinating. 🙂

This weekend I was on a research binge when I came across this comment on one of posts on Your Rainforest Mind.

Once someone has an identity rooted in a disease or disorder, to recover means to lose their identity. If they spend 8 hours a day online with their fellow sufferers, then to recover means to lose a) the main focus of their identity and what they get sympathy and attention for b) their main entertainment/distraction and how they spend their days c) the group of people they have bonded to.

It made me think about how much my own identity is rooted in mental illness. Will I be resistant to getting better?

I decided, quite quickly, that no. I’m not really part of any disability community, although I hope to learn more about disability issues. The idea is that knowing more about the specifics and some of the theory may actually help me advocate for myself better.

I’m not really bonded to people over mental illness. Nor do I really talk about it for attention and sympathy. It is what it is. It impacts my life therefore I will talk about it. Like with birding – I’ll disclose it to let friends know that I may have to sit parts of it out.

There is a strong possibility that things will get better. I’ll find medication, stressors will reduce or I find a specific type of therapy that works. It may take years but life will get better.

When that happens, there will be a period of disorientation. While I’m not attached to my identity as an anxious person, I have had to do a lot of work to become at peace with my limitations. I’ve had to do a lot of self talk, research and other stuff just so I could get through day to day life without beating that up. An improvement of symptoms would mean my reality would change, and so must the narrative I tell myself.

I’ll probably need to be aware of that and maybe even get support throughout the process.

Can you tell I’ve been really getting into the mindmaps lately? This is probably going to turn out horrid – the graphic is far to large.

Anyway, I’ve been experimenting with different kinds of mindmaps to explore different ideas. Some types, like popplet, I like so I can explore the interconnectness of ideas. I’m now experimenting with Mindmeister and the organization chart function so visually lay out ideas. For me, it works better then a list for some reason.

Here is a rough map I whipped up tonight grouping together some impairments. It’s crap, I know that. It was just skimming notes and finding themes.

I probably wont be able to do much work on this stuff until after Tasmania. Even then, I may have difficulty finding time depending on what the job network people want me to do. (That, and I’m debating whether to put recovery stuff on hold and instead focusing on income-creating stuff.)

I’m not even sure how far I want to pursue exploring ideas around giftedness, especially since I’m at the lower end of the spectrum. Other people can do the research. Time *would* probably be better spent on more pressing mental health issues.

I know what you’re thinking. “Barely any posts for weeks and now there is a rush of them over a couple of days?”

Yeah. The admin stuff is over with the disability support network which means we need to get down to the nitty gritty about finding employment. Now I may not be well enough to actually sustain a job for some time. I don’t know that yet. But how can I know anything if I haven’t actually sat down as reassessed my symptoms?

I’ve put off doing this because I just wasn’t stable. Too much stuff was going on. Currently, things are stable. I’m ‘there’ cognitively a lot more then I was last year. I’m also in a completely different position to what I have been in the past. I need to know exactly where I stand so I can advocate for myself and get the best support I can. This girl wants a job! So, here goes.

What is my day to day life like?

Don’t judge me. One of the reasons I am doing so well is because I don’t do anything. I’ve stopped pushing myself. Part of this is because I’m focusing on online projects that may be able to provide an income – something that may benefit me down the track. The other reason is I just don’t have the energy.

I go to the shops. If I’m at my parents, I’ll go adventuring with my nephew. I’ll go to town with Glenn if he asks. Otherwise, I mostly stay at home. I’m quite productive. I clean. I’ve started gardening. I work on online projects and research mental illness stuff. I feel fine most of the time.

You’d think “Well, it seems like you are doing great. Why can’t you get a job?”

I’m doing awesomely because I can manage any symptoms around the illness. I can get extra sleep if I feel a migraine coming on. If I feel exhausted and unable to breath, I can lie on the couch all day and focus on breathing exercises. I have the physical and emotional energy to react when any particular symptom or situation arises.

It’s a luxury and it is one I’ve been incredibly grateful for, especially when my anxiety has been unstable.

What specific symptoms do I get?

Migraines

Migraines are so much fun. So much. I used to get them so much more then I used to – 2/3 times a fortnight. Now I only get 1 once every couple of months… if I live a really boring life and don’t do much.

Waking up early, and pushing myself too hard, are things that seem to trigger it. Which means I have to be incredibly selfish and get 11 hours sleep, plus organize my life so it’s stress free. I also seem to get a lot worse in the summer which I think could be a mixture of heat, light and complete lack of fitness.

I have been recommended some medication but the side effects scare me. I take a naprogesic when I feel the wooziness. This seems to stop it 75% of the time.

I know that increased activity will impact on these symptoms. I need to push myself harder to see where I currently stand. 🙁 I just hate having them, the wooziness is so similar to the old type of dissociation I got.

Dissociation

I don’t dissociate to the same degree I used to, thank gosh. I don’t experience derealization or depersonalization. My eyes go a bit glassy and I struggle to concentrate when I am overwhelmed, but I am connected to reality.

I do have a wacky symptom though that I’m not 100% sure is dissociation. It happens in response to stress or when my body is out of whack. My right arm goes numb, I lose vision for a while and I get extremely nauseous. I describe it as dissociation as the ‘tuning out’ happens a bit slowly so I can feel myself slipping away. I don’t believe it is, at least not in the normal sense. I need to start seeing a regular GP again to sort this out, and to get on top of normal health stuff. Boo!

Sleeping Issues

It can take me 2-3 hours to get to sleep. I do relaxation and breathing. I’ve started journalling before I go to bed, just to clear my head. It’s just my mind is too active. I’m going to be researching and experimenting with specific strategies to help. 🙁 Just writing this, I can see myself getting sick from pushing myself too hard to get better.

I need about 10-11 hours sleep to function. If I have to get up too early, before 10ish, I have incredibly bad insomnia. I have to wake up 3-4 times during the night to pee. Sometimes it can be hard to go back to sleep afterwards.

Currently, I push myself to sleep too much because I wake up terrified. I just don’t want to be awake. When I get up, I’m fine, and can have a relatively productive day. It’s just hard.

Agoraphobia

I’m not scared to leave the house. I just don’t like to, as it leaves me exhausted. Currently, I’ve been doing a lot better then normal (overall) so have been doing a lot of cleaning. I’m on top of housework, I’m getting on top of so many things. It feels awesome to be kinda functional. I worry that by leaving the house, I’ll push myself too hard and get exhausted and end up with 10 loads of washing spread across the house.

So I guess it’s not agoraphobia. It’s complacence. I don’t want to change the status quo. There is also the fact that it is winter and a lot the nature stuff isn’t as fascinating this time of year. I’m doing as much online stuff as I can now so I can do more nature stuff in spring. So, we’ll see how this goes

Hypersensitivity

Previously, hypersensitivity was a symptom that was triggered by the anxiety. There was a distinct physiological … something going on before I could even react to stimuli. I still sometimes get this, although not that often.

I’ve since learned that I am, in many respects, a highly sensitive person. I didn’t believe this before as I did not resonate at all with the first book I read. Now I’m learning that it doesn’t have to be ‘woo woo’. It just means your body reacts in certain ways to certain stimuli.

Now, this hasn’t impacted on me so much as I don’t really put myself in many environments that have potential for overwhelming my senses. I only really go adventuring on my really good days, days where I don’t really notice every noise and movement. I am planning to read up on this further, similar to how I’ve been reading up on giftedness. However, I need a break before another research binge!

Cognitive issues:

My brain is borked. I have difficulties concentrating, my memory is shot. If I’m overwhelmed my brain just shuts down. I get tired very easily. These have improved significantly but again, that’s because I’ve gotten a lot better.

This is the symptom I’m most concerned will impact on any future employment. You can’t CBT away this.

Other symptoms

I don’t get panic attacks any more. Maybe once or twice a year, when under extreme pressure. I don’t get suicidal that often. I’ll sometimes get really tired of things and want a break, but that isn’t connected to thoughts of death.

I get lethargic and tired but it isn’t to the same extent. I get badly depressed and it can last for weeks,

What treatments do I want to explore?

Meditation

7 years ago, my psychologist recommended I explore mindfulness. I tried to get my head around it at the time but just couldn’t figure it out.

My friend has recommended I try the Headspace app, which I’m intrigued about trying. The silly thing is I just can’t be arsed at the moment. It is another expense, another bunch of energy to be expended. Logically I know it will be beneficial and I plan to try it. Sometimes it feels like the I’m always fighting my own brain just to be kinda healthy. The fight is tiring.

EMDR

This stands for Eye Movement Desensitisation Reprocessing (EMDR). My former psychologist also recommended I look into this, although I don’t know if it would be of any benefit. Where do I start, and how much would it cost? I think it is worth the risk.

I will need psychological support during the process, and I think I only get 10 or 12 sessions a year. I really should have sorted all this out when I was getting help through my local Headspace branch.

Exercise

This wont help with my mental health so much. However, I’m at the point where I do fuck all exercise.

Exercise involves leaving the house. I used to be able to do that in my former suburb, when I lived next to the river. I’m in an industrial suburb and I just don’t feel comfortable walking here. I’ve contemplated joining a gym but again, money. How am I going to get ahead if I’m forking out so much money each month?

I have found some exercise videos online that I’m going to put on a USB stick and play through the TV. I just haven’t had the mental energy to that yet, because there is so much else I’m trying to do. I’m bloody exhausted 😛 However I have to be more aggressive with recovering so as to do the right thing by Centrelink.

I’m also hoping to do more hiking. Shorter walks along some tracks, and maybe even long walks along some flat ones.

Find a psychologist

This doesn’t really need expanding on. I have a brilliant mind and can research a lot but I’m not a trained professional. The last support worker I saw even suggested finding a separate counsellor and a psych. The psych can help with the head stuff and a counsellor can help with other strategies. Just be a person I can bounce ideas off. There is even a person there who can help my find the right psychologist.

Supplements

Don’t know if it is even worth going here but it would be worth getting a blood test, especially as I’m such a fussy eater.

~

I’m exhausted and bummed just working through all that, it will probably impact me for a while. And it’s going to be like this everytime I work on getting better 😛 #fail

At the delightful hour of 5.30 this morning, Glenn kissed me goodbye before he went to work. He passed on this little bit of info:

“One of the cats has sprayed over the towels. Could you wash them for me?” Fuuuuuuck!

I was already having a shit nights sleep because I’d planned to go to the Werribee Zoo sleepover with family. I know I shouldn’t be dreading stuff like that, but I’m hitting the point of burnout.

Crap sleep aside, it made me realize something that had changed over the past couple of weeks: I was going downhill when it came to housework and self care again. Before the job network stuff, I was getting my energy back and had turned into a brilliant cleaner. Clothes were washed and put away, we had clean plates and I showered regularly. All of this regression in just a month!

Now that I’ve been pushing myself with this blog, researching and trying to clarify things, I’m feeling considerably more lethargic. Dishes and washing have been mostly forgotten. Mess just stays there. I have to force myself to shower.

It can be easy to think: why is this relevant? Isn’t this another complaint in a long line of complaints?

No. It is data. I have proof that pushing myself, even in a safe environment, is causing side effects. Granted, part of this could be due to a busy weekend at my parents and not having enough time to properly sleep off the exhaustion. However, I’ve visited mum for longer periods in May/June and didn’t crash this bad.

(Note from 2017: I later realised that my anxiety medication had stopped working long ago. I hadn’t realized it because I wasn’t pushing myself. All observations are helpful 🙂 )